title: Immediate effects of active cranio-cervical flexion exercise versus passive mobilisation of the upper cervical spine on pain and performance on the cranio-cervical flexion test.
abstract: This study compared the immediate effects of an assisted plus active cranio-cervical flexion exercise (exercise group) versus a passive mobilisation plus assisted cranio-cervical flexion (mobilisation group) on performance of the cranio-cervical flexion test (CCFT), cervical range of motion (ROM) and pain in patients with chronic neck pain. Eighteen volunteers with chronic idiopathic neck pain participated in the study and were randomised to one of the two intervention groups. Current level of pain, cervical ROM and pain perceived during movement, pressure pain threshold (PPT) and surface electromyography (EMG) during performance of the CCFT were measured before and immediately after the intervention. A significant reduction in resting pain and PPT measured over cervical sites was observed immediately following both interventions, although a greater change was observed for the exercise group. No change in cervical ROM was observed after either intervention. Reduced sternocleidomastoid and anterior scalene EMG amplitude were observed during stages of the CCFT but only for the participants in the active exercise group. Although both active and passive interventions offered pain relief, only the exercise group improved on a task of motor function highlighting the importance of specific active treatment for improved motor control of the cervical spine.
authors.affiliation: Department of Physiotherapy, University of Valencia, Valencia, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Lluch
authors.affiliation: Florastrasse 5, Küsnacht, ZH, Switzerland.
authors.forename: Jochen
authors.initials: J
authors.lastname: Schomacher
authors.affiliation: Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Gizzi
authors.affiliation: Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Petzke
authors.affiliation: Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Seegar
authors.affiliation: Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany; Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology Göttingen, Bernstein Center for Computational Neuroscience, University Medical Center Göttingen, Georg-August University, Göttingen, Germany. Electronic address: deborah.falla@bccn.uni-goettingen.de.
authors.forename: Deborah
authors.initials: D
authors.lastname: Falla
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001269:Atlanto-Occipital Joint / Q000503:physiopathology; D002908:Chronic Disease; D004576:Electromyography / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis / Q000534:rehabilitation*; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: EMG; Exercise; Intervention; Mobilization; Neck pain